手辅助腹腔镜在远端胃癌D2根治术中应用的临床对照研究  

Clinical Comparative Study of Short-Term Outcomes of D2 Radical Distal Gastrectomy for Gastric Cancer Between Hand Assisted Laparoscopic and Traditonal Open Techniques

作　　者：曹永宽[1] 张国虎[1] 王培红[1] 罗国德[1] 张林[1] 刘立业[1] 龚加庆[1] 周均[1] 黄岭[1] 干伟[1] 宋亚宁[1] 

机构地区：[1]成都军区总医院全军普外中心胃肠病区,四川成都610083

出　　处：《中国普外基础与临床杂志》2016年第8期953-956,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的分析手辅助腹腔镜远端胃癌D2根治术的短期临床效果，总结手辅助腹腔镜远端胃癌D2根治术的技术特点。方法回顾性分析成都军区总医院全军普外中心胃肠外科2010年12月至2013年12月期间完成的手辅助腹腔镜远端胃癌D2根治术（手辅助腹腔镜组）92例和传统开腹远端胃癌D2根治术（开腹组）107例患者的临床资料，比较2组的手术时间、手术切口长度、术中出血量、检获淋巴结枚数、术后住院时间及术后并发症。结果手辅助腹腔镜组和开腹组均无手术切缘癌残留。与开腹组比较，手辅助腹腔镜组的手术切口长度明显缩短（P〈0．01），术中出血量明显减少（P〈0．05）；但2组手术时间、检获淋巴结枚数和术后住院时间比较差异无统计学意义（P〉0．05）。手辅助腹腔镜组和开腹组各有1例死亡，均死于不明原因的消化道出血。手辅助腹腔镜组术后共发生并发症9例（9．78％），开腹组术后共发生并发症12例（11．21％），2组术后总并发症发生率比较差异无统计学意义（XZ=9．04，P〉0．05）。结论手辅助腹腔镜远端胃癌D2根治术并未明显延长手术时间，且安全、高效，具有一定的微创优势。Objective To analyze short-term outcomes of hand assisted laparoscopic （HAL） D2 radical distal gastrectomy for gastric cancer and summarize clinical experiences. Methods The clinical data of 199 patients with gastric cancer undergoing D2 radical distal gastrectomy from December 2010 to December 2013 in this hospital were analyzed. HAL （HAL group, n=92） and traditonal open （TO group, n=107） D2 radical distal gastrectomy were performed. The operation time, incision length, intraoperative blood loss, number of lymph nodes harvested, postoperative hospital stay, and postoperative complications were compared between these two groups. Results There was no residue of cancer cells at the surgical margin in the HAL group and the TO group. Compared with the TO group, the average incision length was obviously shorter （P〈0.01） and the average intraoperative blood loss was obviously less （P〈O.05） in the HAL group. The average operation time, the average number of lymph nodes harvested, and the average postoperative hospital stay had no significant differences between the HAL group and the TO group （P〉O.05）. One case was died of unknown gastrointestinal bleeding in the HAL group and the TO group, respectively. The postoperative complication rate was 9.78% （9/92） in the HAL group and 11.21% （12/107） in the TO group, there was no significant difference （P〉O.05）. Conclusions HAL D2 radical distal gastrectomy for gastric cancer don＇t increase operation time. It has some advantages of minimal invasion and safety as compared with traditional open surgery.

关 键 词：胃癌 手辅助腹腔镜 胃癌根治术 

分 类 号：R735.2[医药卫生—肿瘤]